Two Different Surgeons, Two Different Recommendations, Who is Right? (photo)

Hi I am 5'5, weigh 138lb and wear a 34A bra. I have seen 2 different surgeons, I want an E cup and the first surgeon said he would be happy to give me 525 + 460 cc implants but the second surgeon has said he won't put any more than 400 + 375cc in and they should give me a DD. I am confused and don't know who to go with and who is right? I would love some more opinions on what size 400cc would achieve and whether I will be disappointed if I go with the second surgeon? Thanks in advance.

Doctor Answers 8

Two Different Answers

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From your plan, it seems that you want a very large implant. Sometimes that size is not possible with one breast augmentation as the skin and the muscle can only stretch so much. I would suggest you go with the  larger implant as I think that is possible and then six months to a year later when the tissues have finally relaxed, go bigger if you want. I would suggest saline implants for anyone using this strategy because they are adjustable and cost less.

What size implants do you want?

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That is the most important question here.  As mentioned by my colleague, using sizers in stretch cup brassieres can give you an idea of what volume you need for the desired look you want.   Cup size is secondary.  Your surgeon should be able to advise you as to whether your desired size would look appropriate or not on your frame.  Yes, some patients do want totally inappropirate breast sizes and that is for you to work out with your chosen surgeon.  Bottom line, you should have a good idea of what the volumes proposed to you would look like BEFORE your surgery.  Good luck and if your surgeon doesn't provide you the clarity you seek, considering finding another one.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Different Recommendations

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My best advice is to get a tie breaker which will probably lead to more questions but maybe not.  You have to trust your PS or have a gut feeling about who you like. Having said that cup sizes are hard to determine, they vary from victoria's secret to nordstroms, target, etc.  It sounds like you want to be big.  I would go with the PS that will make you the biggest as long as you like him and trust him.

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Two Different Surgeons, Two Different Recommendations, Who is Right?

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I have my patients choose their implant sizes by trying on sizers in a stretch bra and getting a feel for how much volume ( implants come in cc's, not cup sizes) they want to add to their current breast tissue.  Bra cup sizes are not that well standardized, and I do not promise patients that they will achieve a particular cup size.  Also, there are limitations to how large an implant will fit in while still being able to safely close the incisions. And, you say that you want an E cup size but do not say whether you are willing to accept ANY shape of breast no matter how unnatural and obviously implanted they appear.  There is a point in most people where a larger and larger implant starts to look like an overblown balloon depending on the amount and stretchability of your skin and this a result that you are looking for?  And, if choosing a very large implant, you must be willing to accept the long term consequences including stretching and thinning of your tissues and implant "drop out" with possible visible and palpable implant irregularities that may not be correctable.  Some surgeons will try to give you whatever you want regardless of the consequences, and some surgeons will try to convince you to be more realistic so as to protect you from consequences that you may not fully appreciate.

Breast augmentation question.

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I agree that every doctor you see will have a different recoomendation. You appear to be a B cup in your picture with significant stretch marks which tells me your skin may not support an overly large implant. A silicone implant in the range of 500cc should be fine for your frame and choosing a moderate plus or high profile will give you a bigger cup size without being too wide for your frame. Good luck and please see a board certified plastic surgeon.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 60 reviews

Two Different Surgeons, Two Different Recommendations

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The recommendation of size is based on a combination of the patient's objectives, lifestyle, and lifestage, a surgeon's sense of artistic integrity, and the optimal size based on the patient's dimensions. Different surgeons will weigh these factors differently. Size is generally not the most important factor in providing a beautiful breast augmentation result. Choose the surgeon based on his/her experience and expertise, and his/her understanding of your objectives. The surgeon will then be able to recommend the appropriate size to fit your objectives.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 55 reviews

Best Breast Implants for Me?

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Thank you for the question and picture.

Unfortunately, it is impossible to know which plastic surgeon will ultimately “be right”. As you have noted, if you ask 5 plastic surgeons for their opinions, you will receive at least 7 opinions. Different plastic surgeons will give you different opinions based on their training, experience, and personal preferences. This range of opinions you will receive will potentially be confusing.

The best advice I can give you online:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This if communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.
I hope this helps.

What size implant to chose

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Hi, from your description it sounds like you want to be as big as possible considering the jump from A cup (which i dont think you really are) to an E cup. cup sizes and implant sizes do not always correlate directly and my advise to you is to find a board certified plastic surgeon who is willing to explain to you how measurments are done and what they mean and what is the maximum size you can get safely without increased complications.

either one of the 2 surgeons could be right and from one picture and no measurments, it is impossible to predict what implant size will get you to your goal. good luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.